| NPI | 1710999222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A26440) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A26440) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2016-05-05 |