| NPI | 1205984416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 89239) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN MD42586) |
| 207V00000X Obstetrics & Gynecology (Licence: CA C149327) | |
| 207V00000X Obstetrics & Gynecology (Licence: NC 2010-01041) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2025-08-01 |