| NPI | 1992436323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KS 94-11054) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 94-11054) |
| Enumeration Date | 2022-06-17 |
| Last Update Date | 2022-06-17 |