NPI | 1689051666 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WI 75541) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NM MD2019-0189) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-04-29 |
Last Update Date | 2021-12-06 |