| NPI | 1932102944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN MD 27665) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101050784) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2009-09-23 |