| NPI | 1992123061 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KS 05-40104) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2016007201) |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2024-02-07 |