| NPI | 1811982234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY 19204) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35040232S) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2009-03-25 |