| NPI | 1912163320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN 57610) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA ML60018992) |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2018-07-23 |