| NPI | 1538395660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 54515) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 54515) |
| 208M00000X Hospitalist (Licence: MN 54515) | |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2021-03-11 |