| NPI | 1740817824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 73334) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 73334) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: MN 73334) | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: MN 73334) | |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2026-04-30 |