| NPI | 1497066112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 57.018153) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 57.018153) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: OH 57.018153) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2023-02-03 |