| NPI | 1982964524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: TX S2669) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TN 54112) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2020-11-02 |