| NPI | 1407099971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MS 24400) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN 50320) |
| 207V00000X Obstetrics & Gynecology (Licence: LA MD.204972) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2023-08-22 |