| NPI | 1982280947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 0102207807) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0102207807) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-21 |
| Last Update Date | 2023-04-11 |