| NPI | 1003490434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: MN 79745) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX V0373) |
| 208M00000X Hospitalist (Licence: TX V0373) | |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2025-06-16 |