| NPI | 1346277159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: CA A46581) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: CA A46581) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2019-11-23 |