| NPI | 1902193493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 05-36037) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KS 0536037) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2018-06-29 |