| NPI | 1447607387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX S4072) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX BP10057675) |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2024-08-28 |