| NPI | 1174661458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MI 4301072395) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301072395) |
| 207R00000X Internal Medicine (Licence: MI 4301072395) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2015-01-07 |