| NPI | 1326330622 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 58321) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 107610) | 
| 207R00000X Internal Medicine (Licence: MN 58321) | |
| Enumeration Date | 2011-05-05 | 
| Last Update Date | 2023-07-28 |