| NPI | 1487141586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A191425) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101268615) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2025-06-03 |