| NPI | 1962465310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A92178) |
| Additional Taxonomies | 174400000X Specialist (Licence: NV 11159) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2012-10-30 |