| NPI | 1235240870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TX J0606) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: LA 019589) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2011-11-16 |