| NPI | 1265448989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CO 20447) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NM 70-135) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-08-16 |