| NPI | 1154454858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 53711) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A100458) |
| 208M00000X Hospitalist (Licence: MN 53711) | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2017-01-19 |