| NPI | 1235218439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID 2971884) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA g63543) |
| 207V00000X Obstetrics & Gynecology (Licence: AZ 21573) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2026-09-23 |