| NPI | 1376684878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX R3555) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OK 23983) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2022-02-25 |