| NPI | 1063410843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: OH NM-04290) |
| Additional Taxonomies | 176B00000X Midwife (Licence: OH 04290) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2014-02-19 |