| NPI | 1245468396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX T3287) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD452910) |
| Enumeration Date | 2009-06-28 |
| Last Update Date | 2023-05-26 |