| NPI | 1245484146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 55934) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 55934) |
| 208M00000X Hospitalist (Licence: WI 100935) | |
| 208M00000X Hospitalist (Licence: WI 82768) | |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2025-04-16 |