| NPI | 1477977510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CO DR.0068800) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35.139678) |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2022-08-19 |