| NPI | 1568688273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KS 0435452) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-35452) |
| 208000000X Pediatrics (Licence: KS 04-35452) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2020-12-01 |