| NPI | 1104870237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN 016187) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 94254) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2023-03-28 |