| NPI | 1790780831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KS 04-30233) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: KS 04-30233) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2017-11-28 |