| NPI | 1922319375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 57031) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125057386) |
| 207R00000X Internal Medicine (Licence: MN 57031) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2020-10-08 |