| NPI | 1952410037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX L0155) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX L0155) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2023-04-06 |