| NPI | 1457533101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX Q7180) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MS 19933) |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2016-03-31 |