| NPI | 1861756595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101019745) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 68302) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2023-09-06 |