| NPI | 1649267873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN MD0000018720) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN MD0000018720) |
| 208M00000X Hospitalist (Licence: TN 18720) | |
| 208M00000X Hospitalist (Licence: VA 0101276529) | |
| 207V00000X Obstetrics & Gynecology (Licence: VA 0101276529) | |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2025-09-03 |