| NPI | 1578690962 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: WA MD00047747)  | 
| Additional Taxonomies | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: TX L6868)  | 
| Enumeration Date | 2007-02-27 | 
| Last Update Date | 2007-07-16 |