| NPI | 1912069337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ND 12989) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX F0566) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2022-07-21 |