| NPI | 1912200163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY 03668) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IN 02005566A) |
| Enumeration Date | 2010-12-09 |
| Last Update Date | 2023-01-02 |