| 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 |