| NPI | 1831350123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 53539) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 53539) |
| 207R00000X Internal Medicine (Licence: MN 53539) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2020-05-13 |