| NPI | 1376963603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: HI MD-21685) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NV 17753) |
| Enumeration Date | 2014-04-25 |
| Last Update Date | 2021-09-22 |