| NPI | 1770633216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX F6332) |
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: TX F6332) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2010-12-03 |