| NPI | 1891792651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WV 17290) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: WV 17290) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: OH 35065899) | |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: OH 35065899) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2022-04-20 |