| NPI | 1053396200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KS 0528652) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 110366) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2018-11-14 |