| NPI | 1659484103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: WA MD00021261) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AK 4430) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2019-10-09 |