| NPI | 1487988903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 54112) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CO 51384) |
| 207R00000X Internal Medicine (Licence: CO 51384) | |
| 207R00000X Internal Medicine (Licence: MN 54112) | |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2016-12-06 |