| NPI | 1114306123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD465476) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX BP10054318) |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2020-08-28 |