| NPI | 1134485022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 62948) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA 20A13789) |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2018-03-17 |