NPI | 1326488925 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD60859640) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: RI MD15854) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: RI LP02956) | |
Enumeration Date | 2013-06-27 |
Last Update Date | 2020-02-06 |