NPI | 1043502800 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX Q5598) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA OT014145) |
Enumeration Date | 2011-05-11 |
Last Update Date | 2020-10-16 |