| NPI | 1417068065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX G9250) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MS 09665) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |