| NPI | 1265629661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OK 32606) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX N6100) |
| Enumeration Date | 2007-09-29 |
| Last Update Date | 2016-11-30 |