| NPI | 1083705362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX H2358) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR MD217913) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2024-05-29 |