| NPI | 1912985193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME142425) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX L6949) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2025-03-14 |