| NPI | 1114127081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX Q5021) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OK 25841) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2016-03-10 |