| NPI | 1487610705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: TX L8630) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX L8630) |
| 207V00000X Obstetrics & Gynecology (Licence: FL ME98882) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2010-12-10 |