| NPI | 1578711636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: MI 4301092834) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301092834) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301092834) | |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2018-07-03 |