| NPI | 1487968541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA C157619) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX P8492) |
| Enumeration Date | 2010-08-01 |
| Last Update Date | 2022-06-21 |