| NPI | 1396706248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 15840) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN MD19789) |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2021-01-26 |