| NPI | 1730614793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: MI 5101027095) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 34.015859) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-27 |
| Last Update Date | 2024-04-03 |