| NPI | 1316949241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A83399) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101056183) |
| 207V00000X Obstetrics & Gynecology (Licence: UT 6311045-1205) | |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2007-07-08 |