| NPI | 1932309705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 89139) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 212223) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2012-05-11 |