| NPI | 1922740216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX BP10078476) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NM MD2026-0297) |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2026-04-21 |