| NPI | 1972794634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A100959) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: CA A100959) |
| 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: CA A100959) | |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2025-08-23 |