| NPI | 1770590341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD60520385) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 49428) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2017-04-10 |