| NPI | 1760584908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD60094949) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX M2554) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2023-03-07 |