| NPI | 1700172244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 55400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 72482-20) |
| 208M00000X Hospitalist (Licence: MN 55400) | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2021-02-16 |