| NPI | 1639146087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 66908) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35077882) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2023-02-02 |