| NPI | 1477648459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD61034441) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OK 15438) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2022-01-03 |