| NPI | 1669494613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY 21313) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35048903) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2012-12-10 |