| NPI | 1558307264 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: KS 0432050) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KS 04-05812) |
| 207V00000X Obstetrics & Gynecology (Licence: KS 04-32050) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2023-05-11 |