| NPI | 1548612567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: KS 04-45293) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 04-45293) |
| Enumeration Date | 2016-07-02 |
| Last Update Date | 2024-03-28 |