| NPI | 1417927534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A36569) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A39569) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2025-05-19 |