NPI | 1023276748 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX Q4383) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A120756) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN12323) | |
Enumeration Date | 2008-05-29 |
Last Update Date | 2018-05-21 |