| NPI | 1114212677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID M-14987) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA 137748) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2020-02-03 |