| NPI | 1902984867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NV 12925) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A34014) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2017-01-31 |