| NPI | 1366607624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NE 27340) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE TEP5886) |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2016-09-02 |