| NPI | 1780073635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA 155090) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A155090) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2020-07-30 |