| NPI | 1962850024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX S4142) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX BP10057064) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2020-06-30 |