| NPI | 1841785334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 68285) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 68285) |
| 208M00000X Hospitalist (Licence: CA C204837) | |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2025-10-21 |