| NPI | 1508328345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX U1281) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL UO6751) |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2023-07-12 |