| NPI | 1609877562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101033794) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AR C5942) |
| 207V00000X Obstetrics & Gynecology (Licence: TN MD0000016225) | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2014-01-30 |