| NPI | 1235405333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX Q9893) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NM MD2016-0281) |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2016-09-07 |