| NPI | 1932693181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 78667) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2021028090) |
| 207R00000X Internal Medicine (Licence: MN 78667) | |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2025-04-24 |