| NPI | 1073876553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: RI MD15287) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: RI LP02636) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2016-04-07 |