| NPI | 1831351121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA C195956) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD441655) |
| 207V00000X Obstetrics & Gynecology (Licence: AZ 75674) | |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2025-08-07 |