| NPI | 1174905939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 63065) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 263590) |
| 208M00000X Hospitalist (Licence: MN 63065) | |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2020-10-09 |