NPI | 1053422147 |
---|---|
Former Name | KEVIN GOTTLIEB KETTLER |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA 20A8013) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A8013) |
208000000X Pediatrics (Licence: CA 20A8013) | |
Enumeration Date | 2006-08-31 |
Last Update Date | 2024-04-12 |