| NPI | 1619943123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN 8875) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN MD0000008875) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2015-09-30 |