| NPI | 1902867492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 41716) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 41716) |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2020-11-10 |