| NPI | 1649257395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: OH 3897) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: OH 3897) |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2020-12-04 |