NPI | 1326497561 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: ND 16452) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ R75814) |
Enumeration Date | 2016-06-08 |
Last Update Date | 2020-09-03 |