| NPI | 1619968690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX M7823) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: TX M7823) |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2025-12-16 |