| NPI | 1841481629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery (Licence: KS 04-36288) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2021-04-22 |