| NPI | 1255516423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX F-4396) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TX F4396) |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2014-11-11 |