| NPI | 1235221433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KS 0432139) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2022003321) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2023-10-03 |