| NPI | 1063490712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A68974) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NV 9725) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2023-12-22 |