| NPI | 1942509187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 78776) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60457168) |
| 208M00000X Hospitalist (Licence: WA MD60457168) | |
| Enumeration Date | 2011-03-26 |
| Last Update Date | 2025-06-27 |