| NPI | 1861466526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CT 81115) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX E8887) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2025-06-10 |