| NPI | 1932546579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OR DO219433) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2021-02541) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2024-03-28 |