| NPI | 1215912456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 212546) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: MA 212546) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2007-07-08 |