| NPI | 1316095797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX H6642) |
| Additional Taxonomies | 207VB0002X Obstetrics & Gynecology, Bariatric Medicine (Licence: TX H6642) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2018-04-25 |