| NPI | 1316208788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-37734) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 94-08460) |
| 207R00000X Internal Medicine (Licence: AZ R73377) | |
| 208000000X Pediatrics (Licence: AZ R73377) | |
| 208000000X Pediatrics (Licence: KS 94-08460) | |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2018-04-25 |