NPI | 1972605293 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD00033331) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 42504) |
Enumeration Date | 2006-09-05 |
Last Update Date | 2014-02-17 |