| NPI | 1154471944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 94-06676) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2014-01476) |
| 207Q00000X Family Medicine (Licence: KS 04-32272) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2024-03-30 |