| NPI | 1760595029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: CA A44569) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A44569) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2023-12-20 |