| NPI | 1629012877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35-03-5122) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: OH 35.035122) |
| 207V00000X Obstetrics & Gynecology (Licence: WV 15121) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2019-12-17 |