| NPI | 1285994376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MO 2018010763) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 94-07871) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: KY 48018) | |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2018-07-03 |