| NPI | 1972007409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OH 35153935) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 77009-20) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2026-03-18 |