| NPI | 1588868129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NE 24737) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NE 24737) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2015-05-14 |