| NPI | 1679528731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 33103) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35.150758) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2024-06-11 |