| NPI | 1205194271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35129193) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: FL TRN16702) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2024-02-01 |