| NPI | 1780902809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CO DR.0067683) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: TX Q1004) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2023-03-13 |