| NPI | 1518945559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35.057055) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35057055) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2024-02-02 |