| NPI | 1508228750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 4301512511) |
| Additional Taxonomies | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: NJ 25MA11833500) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207V00000X Obstetrics & Gynecology (Licence: OH 35.138777) | |
| Enumeration Date | 2016-03-27 |
| Last Update Date | 2024-09-27 |