| NPI | 1912977463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA 55686) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101235921) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2021-11-30 |