NPI | 1679036396 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A188332) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX 694200) |
Enumeration Date | 2019-04-09 |
Last Update Date | 2023-12-29 |