| NPI | 1093912123 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KS 04-34938) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 04-34938) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2020-02-03 |