| NPI | 1831106665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CA A26210) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A26210) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2007-07-08 |