| NPI | 1386855674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: TX M6581) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX M6581) |
| 207V00000X Obstetrics & Gynecology (Licence: OH 57009336) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2020-01-29 |