| NPI | 1629161252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VE0102X Obstetrics & Gynecology Reproductive Endocrinology (Licence: OH 35051617C) |
| Additional Taxonomies | 207VE0102X Obstetrics & Gynecology Reproductive Endocrinology (Licence: KY KY27720) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2018-12-10 |