| NPI | 1225299290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 68329) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 68329) |
| 207R00000X Internal Medicine (Licence: ND 12920) | |
| 208M00000X Hospitalist (Licence: ND 12920) | |
| Enumeration Date | 2008-06-22 |
| Last Update Date | 2023-03-07 |