| NPI | 1639326010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 46790) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: TN 46790) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2016-11-22 |