| NPI | 1548263627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MS 16676) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN 24170) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2018-10-19 |