| NPI | 1568458263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: OH 35-036032) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35-036032) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2012-10-01 |