| NPI | 1154857902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KS 04-43298) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-43298) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2021-04-01 |