| NPI | 1568782753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX Q9388) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: DC MD042398) |
| 207V00000X Obstetrics & Gynecology (Licence: MD D77822) | |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2016-08-04 |