| NPI | 1225197312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: NV 5561) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: CA A31179) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2007-07-08 |