| NPI | 1083054316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35.155729) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301103079) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2026-05-06 |