| NPI | 1164608535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: KS 04-37866) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 04-37866) |
| 2080P0202X Pediatrics Pediatric Cardiology (Licence: CO DR.0046762) | |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2024-02-01 |