| NPI | 1154016376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KS 94-11473) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-) |
| Enumeration Date | 2023-04-05 |
| Last Update Date | 2026-06-16 |