NPI | 1881658573 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 22572) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 22572) |
Enumeration Date | 2006-04-12 |
Last Update Date | 2011-12-06 |