| NPI | 1053405993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: GA 61881) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX L6230) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-02-01 |