| NPI | 1780223164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 77081) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 177884) |
| 207R00000X Internal Medicine (Licence: MN 77081) | |
| Enumeration Date | 2020-01-02 |
| Last Update Date | 2024-08-06 |