| NPI | 1518985001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301073204) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: MI 4301073204) |
| 207R00000X Internal Medicine (Licence: MI 4301073204) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2012-04-04 |