| NPI | 1114924446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX J8971) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX 08971) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2021-05-18 |