| NPI | 1518142843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35.092402) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX N8235) |
| Enumeration Date | 2008-01-05 |
| Last Update Date | 2022-01-25 |