Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | KH031262 | MI |
NPI | 1093807190 |
---|---|
Provider Name | Kyu Hwang |
First Address | Port Huron, MI 48060-6692 |
Second Address | Port Huron, MI 48060-6692 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 08/07/2007 |