| NPI | 1750301446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX L7784) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2006-00593) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2025-08-15 |