| NPI | 1164733358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA C169249) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA MD60564647) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2024-04-26 |