| NPI | 1497800940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX k4564) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 9300313) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2026-04-07 |