| NPI | 1649362831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA G50159) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G50159) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2021-04-19 |