| NPI | 1851501845 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CO 50541) | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX Q5899) | 
| Enumeration Date | 2007-05-22 | 
| Last Update Date | 2018-04-23 |