| NPI | 1811382971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: TX T6713) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 277974) |
| Enumeration Date | 2015-04-05 |
| Last Update Date | 2022-07-07 |