| NPI | 1891784203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A40451) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NV 5413) |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2013-12-31 |