| NPI | 1780996215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MN 57320) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 4187) |
| 208M00000X Hospitalist (Licence: MN 57320) | |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2023-08-08 |