NPI | 1629343215 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G37501) |
Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CA G37501) |
Enumeration Date | 2012-03-14 |
Last Update Date | 2023-08-29 |