| NPI | 1073516886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN MD31800) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101235080) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2013-09-12 |