| NPI | 1801070156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD60291321) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A101325) |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2013-05-06 |