| NPI | 1245737030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NE 36935) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN 65769) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2025-07-10 |