| NPI | 1295812402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: OR MD25993) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: WA MD60027534) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR MD25993) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2022-02-04 |