| NPI | 1669421103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 3635) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 34-006600) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2014-12-12 |