| NPI | 1558360131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NM A-1602-11) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 2619) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2014-07-16 |