| NPI | 1043380660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G60941) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA g60941) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2024-02-07 |