| NPI | 1790280246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 65936) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 65936) |
| 207R00000X Internal Medicine (Licence: MN 29216) | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2024-01-22 |