| NPI | 1467444828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 30147) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA MD00038457) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2011-06-15 |