| NPI | 1770960544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME148416) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IN 01081854A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2021-07-22 |