| NPI | 1922019819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CA A19096) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A19096) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2015-09-03 |