| NPI | 1649236480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: CA G70376) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G70376) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2020-11-25 |