| NPI | 1013013358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 33525) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A89473) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2013-04-23 |