| NPI | 1417217779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID M-15084) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A128236) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2021-06-09 |