| NPI | 1942760913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX U1955) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 250182) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2023-07-28 |