| NPI | 1184735508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: KS 0418585) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KS 04-18585) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2009-05-04 |