| NPI | 1033195557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA GA19515) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: GA GA19515) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2007-07-08 |