| NPI | 1326488925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WA MD60859640) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: RI LP02956) |
| 207V00000X Obstetrics & Gynecology (Licence: RI MD15854) | |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2026-05-05 |