| NPI | 1063499895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY C4582) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NH 22067) |
| 207V00000X Obstetrics & Gynecology (Licence: SC 18049) | |
| 207V00000X Obstetrics & Gynecology (Licence: OR MD198221) | |
| 207V00000X Obstetrics & Gynecology (Licence: TN 68868) | |
| 174400000X Specialist (Licence: SC 18049) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2025-10-28 |