| NPI | 1912961764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN MD36075) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 36075) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2025-09-03 |