| NPI | 1740571413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 57830) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD 57830) |
| 207R00000X Internal Medicine (Licence: MN 57830) | |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2020-10-08 |