| NPI | 1861420093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: OH 3575461) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35075461) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2021-01-05 |