| NPI | 1316917107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: KS 0521006) |
| Additional Taxonomies | 174400000X Specialist (Licence: KS 05-21006) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2014-08-28 |