| NPI | 1396242186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101276678) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A173426) |
| 207V00000X Obstetrics & Gynecology (Licence: CA A173426) | |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2023-12-10 |