| NPI | 1649245770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35 125599) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: OH 35 125599) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TX H6479) | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2017-11-17 |