NPI | 1912385071 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: TX R4013) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207V00000X Obstetrics & Gynecology (Licence: PA OS020106) | |
Enumeration Date | 2015-05-09 |
Last Update Date | 2023-07-12 |