| NPI | 1841642105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35.128719) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2025010512) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2025-04-01 |