| NPI | 1326011099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: KS 04-53675) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MI 4301060500) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2026-08-06 |