| NPI | 1407858442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TN MD15655) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN MD15655) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2014-02-18 |