| NPI | 1407909971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A87863) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 222608) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-07-30 |