| NPI | 1467411744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A41250) |
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: CA A41250) |
| 208D00000X General Practice (Licence: CA A41250) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2021-05-21 |