| NPI | 1821259110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 53702) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 53702) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2016-06-30 |