| NPI | 1326261041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: PA MW008242L) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: PA UP003424G) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2012-04-11 |