| NPI | 1114268513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: TX U9952) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NE 30086) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-09 |
| Last Update Date | 2024-09-02 |