| NPI | 1225140288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA C55172) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ 32724) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2026-05-20 |