| NPI | 1770589137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: TN MD0000012155) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN MD0000012155) |
| 207V00000X Obstetrics & Gynecology (Licence: TN 12155) | |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2021-07-13 |