| NPI | 1982664553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX E1404) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX E1404) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2008-04-16 |