| NPI | 1437479896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35.133175) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX BP10037521) |
| 207V00000X Obstetrics & Gynecology (Licence: UT 9065004-1205) | |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2022-01-25 |