| NPI | 1922266238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX N9584) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 36796) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2022-01-27 |