| NPI | 1902811474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX Q6677) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NM 97-329) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2023-11-03 |