| NPI | 1134211147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AL 00016070) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX U9637) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2024-03-24 |