| NPI | 1275982720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD61042191) |
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: WA MD61042191) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2021-09-21 |