| NPI | 1356412399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CO CDRH.0064882) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A81943) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2025-09-19 |