| NPI | 1417958042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX E7129) |
| Additional Taxonomies | 261QA0005X Clinic/Center, Ambulatory Family Planning Facility |
| Enumeration Date | 2005-08-04 |
| Last Update Date | 2024-06-13 |