| NPI | 1003058397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101264245) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 262179) |
| 207V00000X Obstetrics & Gynecology (Licence: NH 21210) | |
| 207V00000X Obstetrics & Gynecology (Licence: FL ME146886) | |
| 208600000X Surgery (Licence: NE 6395) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2024-04-24 |