| NPI | 1174840185 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: MI 4301111316)  | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301111316)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-29 | 
| Last Update Date | 2021-03-02 |