| NPI | 1548231186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR MD162221) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA MD00028406) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2018-12-17 |