| NPI | 1619964228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX S8967) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: DE C1-0025369) |
| 207V00000X Obstetrics & Gynecology (Licence: NC 200401375) | |
| 207V00000X Obstetrics & Gynecology (Licence: IN 01065675A) | |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2023-04-24 |