| NPI | 1215147780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX M6091) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M6091) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2021-12-20 |