| NPI | 1689646812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TN MD34780) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CO 47810) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2014-06-11 |