| NPI | 1639272016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL OS10909) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 34005118) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2010-05-27 |