| NPI | 1205396603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 34.015977) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: OH 34.015977) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2023-07-05 |