| NPI | 1508814104 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD61621580) |
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: WA MD61621580) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2025-01-29 |