| NPI | 1447259767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA OP61464097) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CO 46651) |
| 207V00000X Obstetrics & Gynecology (Licence: ID MC-0175) | |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2024-02-01 |