| NPI | 1265419790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 23759) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 23759) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2017-12-22 |