| NPI | 1144612094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 5151012437) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 5101021771) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-02 |
| Last Update Date | 2021-11-24 |