| NPI | 1255302972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD60329790) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA G69005) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2021-06-16 |