| NPI | 1730112608 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 41298) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 41298) | 
| Enumeration Date | 2006-07-07 | 
| Last Update Date | 2018-10-12 |