| NPI | 1497779136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR MD216323) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA MD00042107) |
| 207V00000X Obstetrics & Gynecology (Licence: CA C53962) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2023-09-19 |