| NPI | 1346329497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PR 6482) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: PR 6482) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2012-03-01 |