| NPI | 1902867187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR DO198325) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WY TL6214) |
| 207V00000X Obstetrics & Gynecology (Licence: TX K1389) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2021-02-19 |