| NPI | 1972515112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KS 17559) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 04-17559) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2014-05-12 |