NPI | 1912160763 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX P3246) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2019-02342) |
207V00000X Obstetrics & Gynecology (Licence: FL ME153082) | |
Enumeration Date | 2008-07-02 |
Last Update Date | 2024-05-22 |