| NPI | 1245676683 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 60559) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 63245) | 
| 208M00000X Hospitalist (Licence: MN 60559) | |
| Enumeration Date | 2013-05-13 | 
| Last Update Date | 2022-11-17 |