| NPI | 1265482699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX L0864) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX L0864) |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: TX l086) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2018-08-21 |