| NPI | 1326205980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD60105642) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: NY 003035) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2015-10-06 |