| NPI | 1407090319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: TX P6455) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX P6455) |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2023-11-08 |