| NPI | 1942454699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 155519-1205) |
| Additional Taxonomies | 174400000X Specialist (Licence: UT UT155519-1205) |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2012-09-17 |