| NPI | 1760908933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL OS20658) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2017021204) |
| 207V00000X Obstetrics & Gynecology (Licence: WA pending) | |
| 207V00000X Obstetrics & Gynecology (Licence: WA OP61172813) | |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2024-04-10 |