| NPI | 1568815389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: TX U0626) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MS 27506) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301110771) | |
| Enumeration Date | 2016-07-16 |
| Last Update Date | 2023-09-14 |