| NPI | 1336304906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: ND 12010) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: OH 58.002567) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2025-09-23 |