| NPI | 1225008642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TN 69606) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: KY 40106) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TX U6902) | |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2024-06-07 |