| NPI | 1154403962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MS 20526) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN 41595) |
| 207V00000X Obstetrics & Gynecology (Licence: MD 64864) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2020-04-15 |