| NPI | 1861475915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD00046983) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD00046983) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2025-10-31 |