| NPI | 1629272281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX N4402) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX BP1-0022200) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2018-07-23 |