| NPI | 1508859638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 34007809) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 34007809H) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2017-03-29 |