| NPI | 1922085570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 4766) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX M2051) |
| Enumeration Date | 2005-12-26 |
| Last Update Date | 2022-07-21 |