| NPI | 1013133073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KS 04-33809) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 6574) |
| 207Q00000X Family Medicine (Licence: KS 0433809) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2021-04-27 |