| NPI | 1972898625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MD D0079635) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: DC MD043099) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT 199329) | |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2022-02-04 |