| NPI | 1114238466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KS 35570) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 7521) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2022-06-30 |