| NPI | 1275542672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD60140048) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX M4370) |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: WA MD60140048) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2023-03-07 |