| NPI | 1770746083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OK 5149) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX BP10030675) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2012-06-29 |