| NPI | 1598752669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 34071254) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35071254) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2012-10-01 |