| NPI | 1437200227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CA G56695) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G56695) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2013-03-22 |