NPI | 1386649101 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY 39195) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35. 121252) |
Enumeration Date | 2005-06-17 |
Last Update Date | 2015-07-29 |