| NPI | 1730181462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AK 3291) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX H6545) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2010-12-08 |