| NPI | 1932187788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX J0898) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NV 1126) |
| 207V00000X Obstetrics & Gynecology (Licence: SD 15317) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2024-05-28 |