| NPI | 1184793622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN 60150) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA MD00045856) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2025-07-22 |