| NPI | 1558362608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY 21599) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IN 01034138) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2019-02-19 |