| NPI | 1225050560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 34.007014) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 31-1715747) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2021-02-01 |