| NPI | 1063424166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX R1305) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CT 047354) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2024-01-30 |