| NPI | 1922060243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OK 33361) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX L1191) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2022-09-06 |