| NPI | 1457844458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX T4448) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: RI LP04393) |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2023-10-03 |