| NPI | 1215998612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TN MD39345) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 48446) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2010-08-04 |