| NPI | 1568510907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 59227) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD157557) |
| 207R00000X Internal Medicine (Licence: MT 6978) | |
| 207R00000X Internal Medicine (Licence: MN 108111) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2021-02-02 |