| NPI | 1194802991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA C151485) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: UT 5039763-1205) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2018-03-17 |