| NPI | 1699075440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: VA 0101263895) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57-018710) |
| 207V00000X Obstetrics & Gynecology (Licence: OH 35-123626) | |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2022-04-05 |