| NPI | 1134100308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NH 33730) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35060382) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2024-10-08 |