| NPI | 1295758480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WV 17008) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35.130812) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2021-06-09 |