| NPI | 1710157011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 57453) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 57453) |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2021-03-01 |