| NPI | 1306224514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 64249) |
| Additional Taxonomies | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: MN 64249) |
| 208M00000X Hospitalist (Licence: MA 291675) | |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2024-09-17 |