| NPI | 1588858567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN MD43802) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: TN MD43802) |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2024-12-13 |