| NPI | 1629450275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 94-08740) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KS 0440264) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2018-03-17 |