| NPI | 1083144778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: VA 0101281541) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OK 38003) |
| 207V00000X Obstetrics & Gynecology (Licence: TX BP10060908) | |
| 207V00000X Obstetrics & Gynecology (Licence: TX S8260) | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2025-11-18 |