| NPI | 1376516732 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX L6850) | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IN 01091937A) | 
| Enumeration Date | 2006-02-08 | 
| Last Update Date | 2023-11-07 |