| NPI | 1841406972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A100667) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MT183029) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2013-08-08 |