| NPI | 1508028283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX P3160) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX P3160) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2019-08-16 |