| NPI | 1548521628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 59645) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 59645) |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2023-12-22 |