| NPI | 1134126238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 50646) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 50646) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2021-03-11 |