| NPI | 1902812977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX H0609) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OK 34589) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2025-12-03 |