| NPI | 1114555679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN 76161) |
| Additional Taxonomies | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: FL ME167760) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2026-01-20 |