| NPI | 1699530055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PR 17515I) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 17515I) |
| Enumeration Date | 2024-02-15 |
| Last Update Date | 2026-04-07 |