| NPI | 1609433689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 75066) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04596) |
| 207R00000X Internal Medicine (Licence: MN 75066) | |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2023-11-20 |