| NPI | 1467595405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX K6819) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX K6819) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2022-08-23 |