| NPI | 1356784441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35.137264) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KY 51355) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2020-11-25 |