| NPI | 1043300874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A40710) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: CA A40710) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2026-03-04 |