| NPI | 1255611851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME127418) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX Q8789) |
| Enumeration Date | 2011-08-26 |
| Last Update Date | 2023-11-15 |