| NPI | 1033100532 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR MD10764) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA C54922) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2023-08-16 |