Individual
KENAN QIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01071421A
IN
2080P0205X
Pediatric Endocrinology Physician
01071421A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036106209
—
IL
01
—
32-0149967
GROUP TAX ID
—
Enumeration date
01/11/2007
Last updated
05/05/2015
Update your record
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