| NPI | 1295714780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX R4954) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 44668) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2024-05-28 |