| NPI | 1245473149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: TX R1659) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX BP1003505) |
| 207VX0201X Obstetrics & Gynecology Gynecologic Oncology (Licence: NY 270045) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2022-07-21 |