| NPI | 1114346913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A171965) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CO 0005155) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2021-12-20 |