| NPI | 1255748828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 67269) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 67269-20) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2024-01-29 |