| NPI | 1639155765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NM 80-141) |
| Additional Taxonomies | 174400000X Specialist |
| 207V00000X Obstetrics & Gynecology (Licence: TX R4383) | |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2018-03-02 |