| NPI | 1821161860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA G82337) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G82337) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2025-12-08 |