| NPI | 1184687444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2014-02284) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01054782A) |
| 207Q00000X Family Medicine (Licence: NC 2014-02284) | |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2024-03-08 |