| NPI | 1285138198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: MN 71348) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207V00000X Obstetrics & Gynecology (Licence: VA 0116032028) | |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2024-02-09 |