| NPI | 1053372623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD00034433) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR MD23474) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2023-11-09 |