| NPI | 1518113984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 050670) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN#11326) |
| 207L00000X Anesthesiology (Licence: MA 242580) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CT 050670) | |
| Enumeration Date | 2008-08-17 |
| Last Update Date | 2021-04-16 |