| NPI | 1255375424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 2017-00484) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35046523) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2022-12-23 |