| NPI | 1386094464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: MI 4301502371) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301110238) |
| 207V00000X Obstetrics & Gynecology (Licence: MI 4301502371) | |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2020-05-11 |