| NPI | 1477057529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 73186) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NE 34804) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2023-11-16 |