| NPI | 1285978072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY 48328) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX BP10039753) |
| 207V00000X Obstetrics & Gynecology (Licence: KY TP440) | |
| Enumeration Date | 2012-11-16 |
| Last Update Date | 2022-09-27 |