| NPI | 1093957375 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA A127395)  | 
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MN 106793)  | 
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 57106)  | |
| Enumeration Date | 2009-04-01 | 
| Last Update Date | 2014-11-18 |