| NPI | 1104046887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA G55529) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G55529) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2023-03-07 |