| NPI | 1346202579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX G0817) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AR C5231) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2017-01-02 |