| NPI | 1174889653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN MD0000054664) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN MD0000054664) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2024-09-22 |