| NPI | 1891717088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ID M-11024) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A74177) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2020-05-14 |