| NPI | 1083622294 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CA A24383) | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A24383) | 
| Enumeration Date | 2006-08-03 | 
| Last Update Date | 2007-12-06 |