| NPI | 1003012303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD60902474) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD60902474) |
| Enumeration Date | 2007-06-23 |
| Last Update Date | 2025-10-31 |