| NPI | 1962408161 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35065228) | 
| Additional Taxonomies | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: MI FN059015) | 
| 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: OH 35.065228) | |
| Enumeration Date | 2005-06-22 | 
| Last Update Date | 2022-03-25 |