| NPI | 1346249539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CA G78228) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G78228) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2023-05-23 |