| NPI | 1548213119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0421422) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2008009944) |
| 208M00000X Hospitalist (Licence: MO 2008009944) | |
| 208M00000X Hospitalist (Licence: KS 0421442) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2025-12-12 |