| NPI | 1053441659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KS 0419844) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2004030009) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2007-07-08 |