| NPI | 1124023429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY 35052) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35. 120949) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2023-04-27 |