| NPI | 1326014150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 15906) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35049133) |
| 207V00000X Obstetrics & Gynecology (Licence: CA G57457) | |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2007-07-08 |