| NPI | 1518586874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VC0200X Obstetrics & Gynecology, Critical Care Medicine (Licence: AZ 74712) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: AZ 74712) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2025-07-23 |