| NPI | 1689629271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD00047033) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: ID M-15143) |
| 208M00000X Hospitalist (Licence: ID M-15143) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2025-07-24 |