| NPI | 1225231582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A113001) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NV 12907) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2025-08-04 |