| NPI | 1114160603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA C176908) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2013040208) |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2022-08-22 |