| NPI | 1013925049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD60660936) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 35120020) |
| 207V00000X Obstetrics & Gynecology (Licence: IL 036-081437) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2020-12-01 |