| NPI | 1790929610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX P5792) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX BP10033774) |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2021-01-11 |