| NPI | 1649475260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: VA 0101245365) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 01160017249) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2009-07-15 |