| NPI | 1780046649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: VA 0101277803) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 302069) |
| 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: NY 302069) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2025-01-30 |