| NPI | 1649538927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: KS 04-21126) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MO 2008003302) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: KS 04-21126) | |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2015-03-27 |