| NPI | 1083052211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KS 38331) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 9408216) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2019-06-28 |