| NPI | 1114233996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IN 02004475A) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CT PERMIT) |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2022-10-03 |