| NPI | 1003089160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KS 04-33833) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: KS 04-33833) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2012-03-07 |