| NPI | 1215915194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KS 0444021) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 04-44021) |
| 207R00000X Internal Medicine (Licence: KS 0444021) | |
| 208000000X Pediatrics (Licence: IN 01041325A) | |
| 208D00000X General Practice (Licence: KS 0444021) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2022-09-09 |