| NPI | 1598926669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX P1728) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX BP10031388) |
| Enumeration Date | 2008-06-21 |
| Last Update Date | 2021-12-06 |