| NPI | 1215170717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA 20A13379) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 382791823) |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2014-09-21 |