| NPI | 1992764013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX S2038) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 200500040) |
| 207V00000X Obstetrics & Gynecology (Licence: OH 34006095) | |
| Enumeration Date | 2006-03-18 |
| Last Update Date | 2022-06-30 |