| NPI | 1548220023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX R7203) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR MD22874) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2022-08-17 |