| NPI | 1649321415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OK 26902) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA G070709) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2024-03-02 |