| NPI | 1841601788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX U2126) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD461158) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2025-01-08 |