| NPI | 1528192754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A90045) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC 28776) |
| 207V00000X Obstetrics & Gynecology (Licence: OR MD150774) | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2024-01-02 |