| NPI | 1356378863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CO 37947) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35-081441) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2021-07-29 |