| NPI | 1588019681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: KY 53886) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: FL TRN 23315) |
| 207V00000X Obstetrics & Gynecology (Licence: KY 53886) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2024-01-29 |