| NPI | 1902954837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A79995) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A79995) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A79995) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2025-02-26 |