| NPI | 1558314930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX J0037) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX J0037) |
| 174400000X Specialist (Licence: VA 0101050746) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2023-01-30 |