| NPI | 1801037973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX N6382) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MT188883) |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2015-09-08 |