NPI | 1376005975 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: NC 2024-00046) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-04-02 |
Last Update Date | 2024-01-16 |