| NPI | 1063432797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: TX R9725) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 135124) |
| 207VG0400X Obstetrics & Gynecology Gynecology (Licence: NY 135124) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2022-05-25 |