| NPI | 1154317857 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IA 3413) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MO 2000160646) | 
| Enumeration Date | 2005-09-27 | 
| Last Update Date | 2007-12-18 |