| NPI | 1992140677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TN 64203) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME133051) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2021-08-26 |