| NPI | 1568403244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 19076) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA G59021) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2023-12-20 |