| NPI | 1700316551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MN 67192) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY 55422) |
| 207R00000X Internal Medicine (Licence: MN 67192) | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2021-11-02 |