| NPI | 1689179269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 1020490) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 34.015803) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2024-09-30 |