| NPI | 1134184237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME79290) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35059849p) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2021-09-23 |