| NPI | 1285604090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 47347) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 47347) |
| 207R00000X Internal Medicine (Licence: AZ 20678) | |
| 208M00000X Hospitalist (Licence: AZ 20678) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2021-11-09 |