| NPI | 1184696007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: CA A39024) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A39024) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2024-01-25 |