| NPI | 1093129611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NH 19599) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2014018100) |
| 207V00000X Obstetrics & Gynecology (Licence: NE 30842) | |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2021-04-28 |