NPI | 1568091544 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: CA A197011) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-04-02 |
Last Update Date | 2024-09-05 |