| NPI | 1720027923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY 48842) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A54690) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2020-03-17 |