NPI | 1265057376 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX 176541) |
Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: TX 176541) |
Enumeration Date | 2020-06-15 |
Last Update Date | 2024-05-18 |