| NPI | 1598895955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C36558) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA C36558) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2009-12-02 |