| NPI | 1396709374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 283807) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35065810r) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2021-01-13 |