| NPI | 1023549698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: SC 85420) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 009127) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2021-07-01 |