| NPI | 1205198967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KS 04-39158) |
| Additional Taxonomies | 207RA0000X Internal Medicine Adolescent Medicine (Licence: KS 9407835) |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2023-05-31 |