| NPI | 1790890259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX J6399) |
| Additional Taxonomies | 207VB0002X Obstetrics & Gynecology, Bariatric Medicine (Licence: TX J6399) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2016-11-05 |