| NPI | 1922070242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A96192) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101056144) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2022-10-25 |