| NPI | 1154305175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KS 423578) |
| Additional Taxonomies | 174400000X Specialist (Licence: KS 423578) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2020-03-06 |