| NPI | 1568445005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: TX m1875) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX M1875) |
| 207V00000X Obstetrics & Gynecology (Licence: TX M1875) | |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2017-09-06 |