| NPI | 1710185533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 9406793) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2017002689) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2025-01-20 |