| NPI | 1033525456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 67429) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 67429) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 67429) | |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2024-01-25 |