| NPI | 1700864568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-19720) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2000157954) |
| 208M00000X Hospitalist (Licence: KS 05-19720) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2025-09-11 |