NPI | 1063629673 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CA G39658) |
Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA G39658) |
Enumeration Date | 2007-05-16 |
Last Update Date | 2007-07-08 |