| NPI | 1962610956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: MN 55855) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N0648) |
| 207R00000X Internal Medicine (Licence: MN 55855) | |
| 208M00000X Hospitalist (Licence: MN 55855) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2018-08-06 |