| NPI | 1518096742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN 42379) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 116314) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2021-03-08 |