| NPI | 1356509236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AR E-8936) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX N5196) |
| 207V00000X Obstetrics & Gynecology (Licence: MO 2013014528) | |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2016-01-25 |