| NPI | 1831183797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35049212W) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VT 0420008112) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2007-07-08 |