| NPI | 1083908073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX Q4422) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX BP10040657) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2022-07-14 |