| NPI | 1013932540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: TX F1520) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: NH 15019) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2018-09-24 |