| NPI | 1861441008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD0000024874) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN 24874) |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2018-10-26 |