| NPI | 1629092077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX J2970) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TX J2970) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2015-11-18 |