| NPI | 1124226980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TN MD 11823) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NC 18023) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: GA 030649) | |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: SC 13803) | |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: AL MD 13692) | |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MS 11600) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2007-07-08 |