| NPI | 1265499727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA G57128) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA G57128) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2007-07-08 |