| NPI | 1013090836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID M7348) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA MD000333237) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2016-03-07 |