| NPI | 1881013704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 63569) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 63569) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2018-07-30 |