NPI | 1649393760 |
---|---|
Former Name | KWONG MIN KU |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A77679) |
Additional Taxonomies | 208600000X Surgery (Licence: CA A77679) |
208600000X Surgery (Licence: UT 5941363-1205) | |
Enumeration Date | 2007-04-06 |
Last Update Date | 2020-02-21 |