| NPI | 1477800084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN 31438) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA 46215) |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2021-11-18 |