| NPI | 1124073218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 37412) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 41678-020) |
| 208M00000X Hospitalist (Licence: WI 41678-020) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2021-02-10 |