| NPI | 1356738751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: WA MD61197180) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX S4333) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2022-06-08 |