| NPI | 1992730790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD00023938) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: WA BP0643014) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2012-06-20 |