| NPI | 1093910705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MS 21158) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN 2166) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2016-10-20 |