| NPI | 1386664233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A38660) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A38660) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2021-05-28 |