| NPI | 1861413965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD00044925) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA MD00044925) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: WA MD00044925) | |
| 208800000X Urology (Licence: WA MD00044925) | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2024-08-09 |