| NPI | 1619930328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OK 30150) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX K3559) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2013-09-17 |