| NPI | 1376534875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX L6769) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OK 37095) |
| 207V00000X Obstetrics & Gynecology (Licence: UT 7257858-1205) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2022-07-27 |