| NPI | 1265964092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA 21195) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CA 21195) |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: CA 21195) | |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2023-08-14 |