| NPI | 1508842832 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AR E10563) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX K9136) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2023-05-16 |