| NPI | 1972682011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A68058) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SD 16766) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2025-03-19 |