| NPI | 1285726083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-21032) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 0421032) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-03-19 |