| NPI | 1124655139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-49503) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: LA 335165) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2024-06-28 |