| NPI | 1396788212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35.045973) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: OH 35045973) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2016-01-19 |