| NPI | 1548452915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: HI MD14386) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: NM MD2016-0080) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2022-07-27 |