| NPI | 1760600415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KS 0432190) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KS 6411) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2020-03-18 |