| NPI | 1962850149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 65530) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 69095) |
| 207R00000X Internal Medicine (Licence: MN 65530) | |
| Enumeration Date | 2016-05-30 |
| Last Update Date | 2019-07-30 |