| NPI | 1326664442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: NY 334319) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL ME162293) |
| 207V00000X Obstetrics & Gynecology (Licence: FL 33561) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2023-1253) | |
| Enumeration Date | 2020-06-24 |
| Last Update Date | 2025-08-20 |