| NPI | 1922341791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 62306) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD456094) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-31 |
| Last Update Date | 2022-07-21 |