| NPI | 1730189010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PA MD039524E) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35062638R) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2015-08-24 |