| NPI | 1528043429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AZ 58738) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A50991) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2023-01-13 |