| NPI | 1114408119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: OH 033031) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: OH 033031) |
| 208600000X Surgery (Licence: OH 033031) | |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2018-08-27 |