| NPI | 1417591975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 70559) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND RL15666) |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2022-12-08 |