| NPI | 1932147725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX F7391) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: LA 05783R) |
| 207V00000X Obstetrics & Gynecology (Licence: LA MD.05783R) | |
| 208000000X Pediatrics (Licence: TX F7391) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2021-04-20 |