| NPI | 1851482947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY 39057) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: KY 39057) |
| 207V00000X Obstetrics & Gynecology (Licence: TX L3666) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2024-08-19 |