| NPI | 1487797908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 261463) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35048760) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2011-06-06 |