| NPI | 1043213028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY 27838) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35. 059153) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2015-07-29 |