| 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 |