| NPI | 1568583177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD00020554) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OR MD13645) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2007-07-08 |