| NPI | 1922191337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NV 5611) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA MD61090371) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2021-04-15 |