| 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 |