| NPI | 1215936620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35.034234) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35-03-4234-P) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2009-12-08 |