| NPI | 1356834774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 94-09590) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2024036210) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2024-09-13 |