| NPI | 1174510481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35038401) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35038401B) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2019-05-28 |