| NPI | 1770578551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX L8277) |
| Additional Taxonomies | 207VE0102X Obstetrics & Gynecology Reproductive Endocrinology (Licence: AL 28368) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2022-01-28 |