| NPI | 1124096300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: KS 04-29452) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 0429452) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2023-08-16 |