| NPI | 1942234554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX E 4598) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX E4598) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TX E 4598) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2017-09-15 |