| NPI | 1326193574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX E2750) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX E2750) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2017-11-06 |