| NPI | 1720017601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: TX G3753) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX G3753) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2020-07-14 |