| NPI | 1881702678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR MD23855) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA MD000025542) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2012-05-23 |