| NPI | 1760793657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TN 54179) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX Q0542) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2019-05-17 |