| NPI | 1508872243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA 52223) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A52223) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2016-09-21 |