| NPI | 1083626402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NC 2006-00713) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2006-00713) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2021-01-16 |