| NPI | 1568603413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35093496) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 57.010496) |
| 207V00000X Obstetrics & Gynecology (Licence: MN 56176) | |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2015-08-18 |