| NPI | 1558327957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: CA G42083) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: CA G42083) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2011-02-07 |