| NPI | 1881894715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A94512) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A94512) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2026-01-29 |