| NPI | 1356684609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 59848) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 806159) |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2022-09-07 |