| NPI | 1528406881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A148739) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT204983) |
| 207V00000X Obstetrics & Gynecology (Licence: PA MT204983) | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2020-07-13 |