| NPI | 1730290768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TN 24075) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: TN 24075) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2013-06-24 |