| NPI | 1639408180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 54940) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57012780) |
| 207R00000X Internal Medicine (Licence: WI 54233) | |
| 207R00000X Internal Medicine (Licence: MN 54940) | |
| Enumeration Date | 2009-12-11 |
| Last Update Date | 2020-10-07 |