| NPI | 1346508900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME157623) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX P9913) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2022-10-06 |