| NPI | 1699015032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OK 5865) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 1191) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2023-07-27 |