| NPI | 1518051390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 102763) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 49205) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2017-11-01 |