| NPI | 1073699500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: LA MD.023185) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX L6568) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2021-06-09 |