| NPI | 1326455221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0102207090) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2015-02118) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-07-13 |
| Last Update Date | 2023-12-06 |