| NPI | 1427045335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35031533) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WV 08874) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2007-12-28 |