| NPI | 1134147739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: WA MD00022676) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA MD00022676) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2021-01-19 |