| NPI | 1265966550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 315323) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CO DR.0065863) |
| 208M00000X Hospitalist (Licence: CO DR.0065863) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2023-03-15 |