| NPI | 1417085309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME97991) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35.087342) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2018-09-20 |