| NPI | 1336126374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: CA A106005) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 11423) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2023-03-07 |