Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 57014317 | OH |
NPI | 1497928311 |
---|---|
Provider Name | Cheol Woong Jung |
First Address | Cincinnati, OH 45241 |
Second Address | Cincinnati, OH 45241 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2008 |
Last Update Date | 11/04/2008 |