| NPI | 1649366949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY 46596) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN 62200) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2023-03-01 |