| NPI | 1932139581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: WA 18175) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA 18175) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2019-08-20 |