| NPI | 1417055526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 13260) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A38013) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2011-11-29 |