| NPI | 1659500049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AL AL 30750) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL R10169) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2024-07-02 |