| NPI | 1902862121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A53578) |
| Additional Taxonomies | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: CA A53578) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2021-05-05 |