| NPI | 1275586992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A85480) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A85480) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2012-10-23 |