| NPI | 1407813694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MA 229894) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TX L4917) |
| 207V00000X Obstetrics & Gynecology (Licence: MA 229894) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2009-05-12 |