| NPI | 1881654978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AR C4588) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX N8644) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2015-08-19 |