| NPI | 1487800637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101250340) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 62644) |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2024-07-23 |