| NPI | 1871025619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MB11809100) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX T1730) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2026-03-24 |