| NPI | 1811156227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX Q7614) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MS T1909) |
| 207V00000X Obstetrics & Gynecology (Licence: MS 20765) | |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2020-02-07 |