| NPI | 1366673279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 56446) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 4301089547) |
| 207R00000X Internal Medicine (Licence: MI 4301089547) | |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2013-07-16 |