| NPI | 1932135704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: TX H9682) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX H9682) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2022-01-18 |