| NPI | 1942401492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN 45145) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 127924) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2015-04-07 |