| NPI | 1558707562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 58092) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 58092) |
| 207R00000X Internal Medicine (Licence: PA MD458911) | |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2020-10-08 |