| NPI | 1336382852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 261QM1300X) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208M00000X Hospitalist (Licence: MN 261QM1300X) | |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2014-02-13 |