| NPI | 1609821107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A95374) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CA A95374) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2010-04-19 |