| NPI | 1356351688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD60481560) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX L5224) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2021-03-16 |