NPI | 1538276613 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD00035083) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR MD20512) |
Enumeration Date | 2006-08-24 |
Last Update Date | 2022-02-10 |