| NPI | 1417937145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VB0002X Obstetrics & Gynecology, Bariatric Medicine (Licence: KS 04-23518) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KS KS 04-23518) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2011-11-02 |