| NPI | 1063473841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: WA 60033065) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: ID M-10613) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2011-07-21 |