| NPI | 1154883213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 13103714-1204) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: UT 13103714-8904) |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2023-06-29 |