| NPI | 1528486370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0439793) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KS 0439793) |
| Enumeration Date | 2014-03-30 |
| Last Update Date | 2020-03-19 |