NPI | 1689931933 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX R0360) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA OP60816519) |
Enumeration Date | 2012-04-11 |
Last Update Date | 2021-07-29 |