| NPI | 1912249012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: WA MD60741917) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA ML60363856) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2025-03-12 |