| NPI | 1851737647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: KS 04-48038) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 94-08150) |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2023-08-03 |