| NPI | 1295062347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX p6826) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 21158) |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2021-12-08 |