| NPI | 1467423053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: OH 35-078905) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35078905J) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2012-05-18 |