| NPI | 1790149425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA A151432) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD471536) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2024-06-21 |