| NPI | 1407904303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NM 82-132) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA C42541) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2013-09-01 |