| NPI | 1538166970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 56029) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TN MD0000044259) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2024-03-05 |