| NPI | 1326071903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 430503) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-30503) |
| 208000000X Pediatrics (Licence: KS 04-30503) | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2023-02-01 |