| NPI | 1790361301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MD D0102753) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116035390) |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2025-07-17 |