| NPI | 1316145303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A111405) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101244057) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2023-07-19 |