| NPI | 1649244039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX E0583) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: LA 012027) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2022-02-11 |