| NPI | 1790734119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: OH 35.050590) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35050590) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2014-10-07 |