| NPI | 1750844908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN 71131) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA MD61411043) |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2025-03-24 |