| NPI | 1942527734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 9069040-1205) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: UT 9069040-8905) |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2022-01-21 |