| NPI | 1184917833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY 45549) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 57.015507) |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2018-09-14 |