| NPI | 1386333706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 77481) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 77481) |
| 207R00000X Internal Medicine (Licence: MN 33398) | |
| Enumeration Date | 2023-05-02 |
| Last Update Date | 2026-06-25 |