| NPI | 1750634036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WI 71044) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX BP10042990) |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2023-02-03 |