| NPI | 1356439228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35-049315) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35--049315) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2021-10-27 |