| NPI | 1376866590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: WA MD 00025406) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: ID M 5392) |
| Enumeration Date | 2010-03-02 |
| Last Update Date | 2012-10-04 |