| NPI | 1962499194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TN MD8094) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN MD0000008094) |
| 208600000X Surgery (Licence: TN MD0000008094) | |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2018-03-08 |