| NPI | 1922113638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR MD07825) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA MD00014396) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2007-07-11 |