| NPI | 1194939264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: OH 35-120786) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MA 243545) |
| 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: KY 45937) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2019-11-15 |