| NPI | 1902013238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: AR E-14959) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN MD046284) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2025-10-24 |