| NPI | 1093929630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A103922) |
| Additional Taxonomies | 207VH0002X Obstetrics & Gynecology, Hospice and Palliative Medicine (Licence: MI 4301080639) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2011-08-04 |