| NPI | 1053488353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN DO0000001147) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN D0001147) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2015-08-14 |