| NPI | 1205877214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX N4264) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CT 034987) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2019-11-22 |