| NPI | 1598393167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD70115447) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: DC CS2100013422) |
| 208600000X Surgery (Licence: DC CS2100013422) | |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2026-08-04 |