| NPI | 1194012906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX R7227) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX BP10041667) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2018-07-25 |