| NPI | 1447784061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD61170516) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA BC61191881) |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2025-07-04 |