| NPI | 1033169818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: TX G8740) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX G8740) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2022-05-18 |