| NPI | 1972923381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 292057) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35.134738) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2025-03-19 |