| NPI | 1720600752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN 76862) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: LA 344291) |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2026-07-17 |