| NPI | 1962445593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX F6525) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: TX F6525) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2018-05-21 |