| NPI | 1285051565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 67011) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A147221) |
| 207R00000X Internal Medicine (Licence: MA 269436) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 67011) | |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2022-07-01 |