| NPI | 1518916501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX M3275) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA OS012463) |
| 207V00000X Obstetrics & Gynecology (Licence: OH 34.008226) | |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2023-03-07 |