| NPI | 1912952862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35-10-0312-C) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WV WV10438) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2008-03-13 |