| NPI | 1033113055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD60636844) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: OR MD 23534) |
| 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: OR MD 23534) | |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2024-01-19 |