| NPI | 1376037119 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 72819) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 52480) | 
| 207R00000X Internal Medicine (Licence: SC LL52480) | |
| 208M00000X Hospitalist (Licence: SC 86389) | |
| 208M00000X Hospitalist (Licence: SC 52480) | |
| Enumeration Date | 2018-06-15 | 
| Last Update Date | 2025-03-27 |