| NPI | 1821072216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KS 530033) |
| Additional Taxonomies | 174400000X Specialist (Licence: KS 530033) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2012-05-24 |