| NPI | 1649331497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX E7917) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TX E7917) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2021-06-08 |