| NPI | 1285073338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR DO195172) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207V00000X Obstetrics & Gynecology (Licence: IL 125.06822) | |
| 208600000X Surgery (Licence: OR PG172039) | |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2021-03-15 |