| NPI | 1881645224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: KS 0428146) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0428146) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2023-10-27 |