| NPI | 1669431094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX H2010) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX R0003) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2017-03-13 |