| NPI | 1154315158 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 42334-20) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 42334) | 
| 208M00000X Hospitalist (Licence: WI 42334) | |
| Enumeration Date | 2005-09-06 | 
| Last Update Date | 2021-01-21 |