| NPI | 1396778973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: KS 04-31957) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TN 31074) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2018-03-16 |