| NPI | 1851522486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MA 258209) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 54025) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-07-30 |
| Last Update Date | 2024-12-24 |