| NPI | 1336257138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA G86802) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NV 8599) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2008-11-21 |