| NPI | 1538590088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: NY 283548) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: NY 283548) |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2020-12-07 |