| NPI | 1437444262 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX Q6314) | 
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN 52960) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-09 | 
| Last Update Date | 2023-12-15 |