| NPI | 1568482255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 9600266) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX Q3872) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2024-11-18 |