| NPI | 1164785317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 56536) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 56536) |
| 207R00000X Internal Medicine (Licence: WI 77535-20) | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2024-04-23 |