| NPI | 1356575492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN 49225) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 49225) |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2018-04-09 |