| NPI | 1598969172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX Q2166) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA MD60302817) |
| 207V00000X Obstetrics & Gynecology (Licence: CT 76089) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2023-11-10 |