| NPI | 1639150485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VH0002X Obstetrics & Gynecology Hospice and Palliative Medicine (Licence: UT 6029113-1205) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A70615) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2011-12-12 |