| NPI | 1073711156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA C54829) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35.090050) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2018-02-27 |