| NPI | 1689849622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 6917) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KS 33913) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2018-11-19 |