NPI | 1760678692 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A108823) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57-013424) |
Enumeration Date | 2007-09-25 |
Last Update Date | 2012-07-03 |