| NPI | 1437181922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A47906) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A47906) |
| 208000000X Pediatrics (Licence: CA A47906) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2021-04-14 |