| NPI | 1275023228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX T4843) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MT214848) |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2023-07-18 |