| NPI | 1871518969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: OR MD09743) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OR LF00001937) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2013-08-06 |