| NPI | 1659435204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 49585) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 49585) |
| 208M00000X Hospitalist (Licence: ND 9616) | |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2020-11-10 |