| NPI | 1821403783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 62426) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 62426) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 62426) | |
| 208M00000X Hospitalist (Licence: FL ME170301) | |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2025-01-03 |