| NPI | 1588659460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NV 11582) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX K3036) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2024-02-05 |