| NPI | 1588784508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A47748) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A47748) |
| Enumeration Date | 2007-03-31 |
| Last Update Date | 2008-05-01 |