| NPI | 1215985932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 254747) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A86887) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2021-11-30 |